scholarly journals Major Aortic Reconstruction with the Replacement of Supra-Aortic Branches: Successful Surgical Treatment of Takayasu Arteritis Initially Presented as Congestive Heart Failure

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 216
Author(s):  
Maja Stojanovic ◽  
Sanvila Raskovic ◽  
Marija Boricic-Kostic ◽  
Vesna Bozic ◽  
Maja Vuckovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Takayasu Arteritis ◽  
Morphological Changes ◽  
Pulmonary Arteries ◽  
Uneventful Recovery ◽  
Severe Aortic Regurgitation ◽  
Bentall Procedure ◽  
One Year ◽  
Arch Reconstruction

Takayasu arteritis (TA) is a rare, large vessel vasculitis that affects aorta, its major branches, and occasionally pulmonary arteries. Patients with TA can present with constitutional features and/or various symptoms and signs caused by morphological changes in the blood vessels affected by the inflammatory process. Corticosteroids (CS) and immunosuppressives (IS) are the first line treatment for active TA. Open surgery remains a treatment of choice for TA patients with moderate-to-severe aortic regurgitation (AR) and ascending aortic aneurysm (AAA). We present a 26-year-old female diagnosed with an advanced stage of TA, initially presented as congestive heart failure. Due to a progressive course of the disease (AR 3+, AAA 5.5 cm), surgery of the Aortic valve and root (Bentall procedure), with total arch reconstruction and replacement of supra-aortic branches was performed. The patient has had an uneventful recovery during the postoperative course with no complications at one year follow-up. Normal left ventricle (LV) diameter, LV ejection fraction 67%, and a trace of AR were seen on the last echocardiography.

The Halting Shadow

2017 ◽  
Author(s):  
Deirdre David
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Sexual Desire ◽  
Respiratory Illness ◽  
Perforated Ulcer ◽  
Respiratory Illnesses ◽  
Dylan Thomas ◽  
One Year

The last years of Pamela’s life were marked by further illness but also by a remarkable dedication to work. She was hospitalized several times for respiratory illnesses, but in 1974 she published a book of autobiographical essays, Important to Me, which covered such topics as memories of her father, her relationship with Dylan Thomas, her visits to the USSR, and her friendship with other writers such as Edith Sitwell. After months of undiagnosed pain, Snow died in 1980 of a perforated ulcer and Pamela died almost one year later of congestive heart failure and respiratory illness exacerbated by having smoked since the age of fourteen. Yet characteristically she worked courageously until the very end on a novel published posthumously: A Bonfire, which similarly to her first novel deals explicitly with sexual desire. Her ashes were scattered at Stratford-upon-Avon, a place she visited every year on Shakespeare’s birthday.

scholarly journals Trends in mortality, co-morbidity and treatment after acute myocardial infarction in patients with rheumatoid arthritis 1998–2013

2020 ◽  
Vol 9 (8) ◽  
pp. 931-938 ◽  
Author(s):  
Mattias Skielta ◽  
Lars Söderström ◽  
Solbritt Rantapää-Dahlqvist ◽  
Solveig W Jonsson ◽  
Thomas Mooe
Keyword(s):  
Rheumatoid Arthritis ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Acute Myocardial Infarction ◽  
Congestive Heart Failure ◽  
Cox Regression Analysis ◽  
Co Morbidity ◽  
One Year ◽  
Over Time

Aims: Rheumatoid arthritis may influence the outcome after an acute myocardial infarction. We aimed to compare trends in one-year mortality, co-morbidities and treatments after a first acute myocardial infarction in patients with rheumatoid arthritis versus non-rheumatoid arthritis patients during 1998–2013. Furthermore, we wanted to identify characteristics associated with mortality. Methods and results: Data for 245,377 patients with a first acute myocardial infarction were drawn from the Swedish Register of Information and Knowledge about Swedish Heart Intensive Care Admissions for 1998–2013. In total, 4268 patients were diagnosed with rheumatoid arthritis. Kaplan-Meier analysis was used to study mortality trends over time and multivariable Cox regression analysis was used to identify variables associated with mortality. The one-year mortality in rheumatoid arthritis patients was initially lower compared to non-rheumatoid arthritis patients (14.7% versus 19.7%) but thereafter increased above that in non-rheumatoid arthritis patients (17.1% versus 13.5%). In rheumatoid arthritis patients the mean age at admission and the prevalence of atrial fibrillation increased over time. Congestive heart failure decreased more in non-rheumatoid arthritis than in rheumatoid arthritis patients. Congestive heart failure, atrial fibrillation, kidney failure, rheumatoid arthritis, prior diabetes mellitus and hypertension were associated with significantly higher one-year mortality during the study period 1998–2013. Conclusions: The decrease in one-year mortality after acute myocardial infarction in non-rheumatoid arthritis patients was not applicable to rheumatoid arthritis patients. This could partly be explained by an increased age at acute myocardial infarction onset and unfavourable trends with increased atrial fibrillation and congestive heart failure in rheumatoid arthritis. Rheumatoid arthritis per se was associated with a significantly worse prognosis.

scholarly journals Infective Endocarditis Complicated with Progressive Heart Failure due to β-Lactamase-Producing Cardiobacterium hominis

2000 ◽  
Vol 38 (5) ◽  
pp. 2015-2017 ◽  
Author(s):  
Po-Liang Lu ◽  
Po-Ren Hsueh ◽  
Chien-Ching Hung ◽  
Lee-Jene Teng ◽  
Tsrang-Neng Jang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Blood Isolate ◽  
Severe Aortic Regurgitation ◽  
Progressive Heart Failure ◽  
Resistance To Penicillin ◽  
High Level ◽  
Level Resistance

We describe a 66-year-old woman with infective endocarditis due toCardiobacterium hominis whose condition, complicated by severe aortic regurgitation and congestive heart failure, necessitated aortic valve replacement despite treatment with ceftriaxone followed by ciprofloxacin. The blood isolate of C. hominis produced β-lactamase and exhibited high-level resistance to penicillin (MIC, ≧256 μg/ml) and reduced susceptibility to vancomycin (MIC, 8 μg/ml).

Abstract 630: Continuous Reduction of N-Terminal Pro-Brain Natriuretic Peptide Levels after Successful Catheter Ablation in Patients with Paroxysmal or Short Persistent Atrial Fibrillation

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Simon Hoenig ◽  
Robert Hofmann ◽  
Clemens Steinwender ◽  
Alexander Kypta ◽  
Franz Leisch
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Congestive Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Success ◽  
Clinical Signs ◽  
Small Sample ◽  
Clinical Failure ◽  
One Year

It has been reported previously that elevated N-terminal pro-brain natriuretic peptide levels (BNP) decrease in patients with atrial fibrillation (AF) within one month of pulmonary vein isolation (PVI). The purpose of the study was to examine the development of BNP levels after successful PVI. In 71 patients (mean age of 62 ± 8 years) undergoing successful PVI for drug-resistant highly symptomatic paroxysmal or shortly persistent AF, BNP levels were analysed the day before, 30 days after, three months after and one year after the procedure, respectively. Based on a personal log of duration and frequency of symptoms and repetitive 24h-ECG recordings, patients were divided into two groups: 36 patients had clinical success, and 16 patients had clinical failure. Clinical demographic and procedural data were similar in both groups. Of note, all patients had lone AF without any clinical signs of congestive heart failure. Baseline BNP levels were similar in both groups (387± 550 pg/ml vs. 492 ± 513 pg/ml, p=0.6). After 30 days, patients who had a clinical successful procedure showed a significant decrease of BNP levels compared to those patients with clinical failure (315 ± 430 pg/ml vs. 754 ± 888 pg/ml, p=0.02). After three months, a further reduction of BNP levels could be observed in clinical successful treated patients compared to patients with clinical failure, in whom no significant change compared to baseline could be detected (214 ± 213 pg/ml vs. 673 ± 907 pg/ml, p=0.01). After one year of successful PVI a repeated reduction of BNP in patients with clinical success could be observed (173 ± 198 pg/ml vs. 448 ± 628 pg/ml, p=ns.), but due to the small sample size the difference did not reach statistic significance. Similar to previous observations, BNP levels after successful PVI decreased only in patients with clinical success during follow-up. However, our study revealed a long-term effect showing a further decrease after one year whereas BNP levels showed even a further increase during the first three months in patients without clinical success. This observation points to an underestimated impact of AF concerning congestive heart failure even in patients without regarding symptoms.

scholarly journals Congestive heart failure alters receptor-dependent cAMP-mediated relaxation of canine pulmonary arteries.

Circulation ◽  
1993 ◽  
Vol 87 (5) ◽  
pp. 1722-1728 ◽  
Author(s):  
R Mathew ◽  
J Wang ◽  
M H Gewitz ◽  
T H Hintze ◽  
M S Wolin
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pulmonary Arteries

scholarly journals Morphologic and morphometric evaluation of pancreatic islets in chronic Chagas' disease

2001 ◽  
Vol 56 (5) ◽  
pp. 131-138 ◽  
Author(s):  
João Carlos Saldanha ◽  
Vitorino Modesto dos Santos ◽  
Marlene Antônia dos Reis ◽  
Daniel Ferreira da Cunha ◽  
Vicente de Paula Antunes Teixeira
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Pancreatic Islets ◽  
Chagas Disease ◽  
Morphological Changes ◽  
Tail Region ◽  
Functional Changes ◽  
Glucose Tolerance Tests ◽  
Morphology And Morphometry ◽  
Chronic Chagas Disease

PURPOSE: Hyperglycemia and abnormal glucose tolerance tests observed in some patients with chronic Chagas' disease suggest the possibility of morphological changes in pancreatic islets and/or denervation. The purpose of this study was to describe the morphology and morphometry of pancreatic islets in chronic Chagas' disease. METHODS: Morphologic and computerized morphometric studies were performed in fragments of the head, body, and tail regions of the pancreas obtained at necropsies of 8 normal controls and 17 patients with chronic Chagas' disease: 8 with the digestive form (Megas) and 9 with the congestive heart failure form. RESULTS: The Megas group had a larger (p < 0.05) pancreatic islet area in the tail of the pancreas (10649.3 ± 4408.8 µm²) than the normal control (9481.8 ± 3242.4 µm²) and congestive heart failure (9475.1 ± 2104.9 µm²) groups; likewise, the density of the pancreatic islets (PI) was greater (1.2 ± 0.7 vs. 0.9 ± 0.6 vs. 1.9 ± 1.0 PI/mm², respectively). In the tail region of the pancreas of patients with the Megas form, there was a significant and positive correlation (r = +0.73) between the area and density of pancreatic islets. Discrete fibrosis and leukocytic infiltrates were found in pancreatic ganglia and pancreatic islets of the patients with Chagas' disease. Trypanosoma cruzi nests were not observed in the examined sections. Individuals with the Megas form of Chagas' disease showed increased area and density of pancreatic islets in the tail of the pancreas. CONCLUSION: The observed morphometric and morphologic alterations are consistent with functional changes in the pancreas, including glycemia and insulin disturbances.

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